and all need highly specialized care and intensive medical management.

Douglas Mann, MD, Chief of the Cardiovascular Division, spearheaded efforts to add the new critical care cardi-ology section and has fostered collabora-tions with colleagues in pulmonology and critical care medicine to create the new

model of care. It includes the addition of two new cardiology faculty whose primary responsibility will be to help care for patients in the CCU, which now handles more than 2,000 admissions annually. Dr. Bria Giacomino completed a cardiology fellowship at the University of

Washington University Cardiology Alumni Newsletter | 1

The mission of the Washington University and Barnes-Jewish Heart & Vascular Center is to achieve excellence in patient care, research and education through seamless integration of heart and vascular care. The Heart and Vascular Center is committed to promoting heart and vascular health through education, prevention and treatment of heart and vascular disease.

The Cardiovascular Division at Washington University School of Medicine has estab-lished a new Section of Critical Care Cardi-ology and is changing how it approaches the care of patients admitted to the coro-nary care unit. In addition, in collaboration with the Division of Pulmonary and Criti-cal Care Medicine, the division is planning to offer a one-year advanced fellowship pathway in critical care cardiology.

“This is an evolving subspecialty in cardiology because patient demographics in CCUs have been evolving over the past decade,” says Richard Bach, MD, medical director of the CCU at Barnes-Jewish Hospital for more than 20 years and head of the new section. “To manage the complex and critically ill patients in the modern CCU now demands a broader knowledge of intensive care in addition to cardiology expertise.”

CCUs were initially designed 50 years ago to care for patients diagnosed with acute myocardial infarction, or MI. Those patients had a high risk of death and CCUs had cardiologists, nurses and trained staff to rapidly handle rhythm disturbances at any time. Because of that approach with routine CCU care, the MI mortality rate in its day dropped by half, from 30 percent to 15 percent. Fast forward to today’s CCU, and uncomplicated MI patients account for a small portion of patients. The majority now are patients with cardio-genic shock, severely decompensated con-gestive heart failure and serious arrhyth-mias. Many require mechanical ventilation or cardiac support devices

WA S H I N G T O N U N I V E R S I T Y A L U M N I N E W S L E T T E R Summer 2019

CARDIOLOGY

Continued on page 5

A New Era Emerging in CCU Care

Cardiologists in the new Section of Critical Care Cardiology include David Schwartz, MD, Section Director Richard Bach, MD, and new faculty members Adam May, MD, and Bria Giacomino, DO.

Gregory A. Ewald, MD, FACC, has been named acting chief of the Cardiovascular Division. He takes the helm as Douglas Mann, MD, the

Tobias and Hortense Lewin Professor and Director of the Cardiovascular Division, steps down to focus on research efforts and spend more time with his family.

Ewald, Professor of Medicine, is current-ly the Chief of Clinical Cardiology and Director of the Section of Heart Failure and Cardiac Transplantation. He has been a member of the division since 1997, joining the faculty after completing both his resi-dency in internal medicine and fellowship in cardiology at Washington University School of Medicine/Barnes-Jewish Hospital. In addition to his roles at Washington University, Ewald serves as cardiac medical director for Mid-America Transplant, the regional organ procurement organization. Since 1997, he consistently has been funded

by the National Institutes for Health (NIH) and other organizations for clinical research into new therapeutics to better evaluate and treat heart failure.

“During Doug’s tenure, we made a lot of strides to enhance our strengths in basic research as well as develop a robust infra-structure to support clinical research,” says Ewald. “He has been a fantastic mentor to our fellows and junior faculty. I have been fortunate to work closely with him during the past 10 years and hope to continue those traditions as we move through this transitional period.”

As you can see by our lead story, our division continues to evolve to enhance patient care and education. I’m very proud that we consistently remain at the forefront of our field and have often identified — and implemented — ways that make a difference in the care of our patients and in how we teach the next generation of cardiologists and cardiovas-cular specialists.

As programs evolve, so, too, does leadership. In May, I decided to step down as Chief of the Cardiovascular Division. I remain on faculty and will spend my time doing what I love to do: caring for patients and continuing my long-standing research into the molecular and cellular basis of heart failure. The change also will allow me to spend more time with my family, something that I enjoy immensely.

Greg Ewald, MD, chief of clinical cardiology and director of our Section of Heart Failure and Cardiac Transplantation is serving as acting chief. Many of you know Greg. He has spent his entire medical career at Washington University, completing his residency and then a fellowship in cardiology before joining the faculty in 1997. He’s also been my right-hand man, serving

MESSAGE FROM THE CHIEF

Contact Information

Cardiovascular DivisionWashington University School of Medicine Campus Box 8086 660 S. Euclid Ave. St. Louis, MO 63110

Administration Office314-747-3031

Fellowship Office314-362-1297 Laura King, coordinator lking@wustl.edu

On the web: cardiology.wustl.edu

Toll-Free Appointment Line:888-210-8375

Douglas L. Mann, MDLewin Professor and Chief, Cardiovascular Division

If you are interested in making a donation to the Cardiovascular Division, please contact Rachel A. Hartmann in the Washington University Medical Alumni and Development office at: 314-935-9715 or rachel_hartmann@wustl.edu

Washington University in St. Louis Office of Medical Alumni and Development Attn: Rachel A. Hartman Campus Box 1247 7425 Forsyth Blvd. St. Louis, MO 63105

2 | Washington University Cardiology Alumni Newsletter

Douglas Mann, MD

Ewald Named Interim Chief, Cardiovascular Division

in several administrative roles over the years. I know that Greg will do an amazing job as the interim chief and continue to move the division forward.

When I arrived at Washington University School of Medicine in 2009, I recognized that I was standing on the shoulders of those who already had made outstanding contributions to the field of cardiology. It has been an honor and a privilege to lead this division and I cherish the opportunities I have had to learn from others, mentor future physician-scientists, conduct invigorating research, and work side by side with extraordinary faculty and staff.

I also am proud of the establishment of the Smith-Oliver Society during my tenure, our way of connecting cardiology alumni to this esteemed institution no matter where they are around the world. I encourage you to keep in touch. We always are interested in your career paths and hope you remain proud of being part of this legacy of cardiovascular excellence at Washington University School of Medicine.

Address Change or Emailed Newsletter? If you would like to receive communications from the Cardiovascular Division electronically or have an address change, please email kateschoellhorn@wustl.edu.

Fellowship Program Update Andrew Kates, MD

Alumni UpdateAnu Rao, MDCardiovascular Fellow, 2008-2011Chief Fellow, 2009-2011

Currently: Rao is Director of the Echocardiography Lab and Acting Sec-tion Chief of Noninvasive Cardiology at Rush University Medical Center, Chi-cago, IL. She completed her cardiology fellowship at Washington University and a subspecialty fellowship in advanced cardiac imaging in the Laboratory of Cardiac Energetics at the National Heart, Lung and Blood Institute in Bethesda, MD. She also worked as a Medical Officer at the NIH. Concurrently, she worked as an assistant professor in the Division of Cardiovascular Medicine at the University of Maryland Medical Center and as an attending cardiologist at MedStar Washington Hospital Center in Washington, D.C.

Rao’s research focus is on multimodality imaging of myocardial function in valvular heart disease. A strong advocate of fellowship training and mentoring, Rao was named Teacher of the Year in 2018 in Rush’s Division of Cardiology.

Favorite Leisure Activ-ities: Most of my time outside of the hospital is spent with my family and parenting our 8-year-old twin boys. We love to travel, spend time outdoors, and do art-work and other creative

FELLOWSHIP & ALUMNI NEWS

Washington University Cardiology Alumni Newsletter | 3

projects. We also like to discover new restaurants and museums. Because of all the boys in our house, I have gone from being completely sports-illiterate to being inundated with all aspects of the NBA and NFL!

Favorite Fellowship Memories: My favorite memories include my time in the echo lab. My interest in imaging was sparked by the excellent WU facul-ty. I still hear Majesh’s voice in my head saying “mitral regurgitation from here to Australia” and his use of exclamation marks for remarkable findings in echo reports. A highlight was working with co-fellows and the echo attendings on the first WU echo manual. I also remember how excited and awestruck I was when I scrubbed in on our very early Mitra-Clip cases. I spent a lot of time with the valve team in those days and got invaluable experience with TAVR and aortic valve disease. Wash

U was always at the forefront of cutting edge treat-ments. We were so fortunate to have been exposed to all aspects of adult congenital heart disease, which is very unique to this program. I remember fondly the camaraderie of my co-fellows and I still keep in touch with many of them as we have formed lifelong friendships.

Anu Rao, MD (below, right) with her husband Dilip Nath, MD, and their twin boys on a recent trip to Costa Rica.

Departing FellowsThe following fellows have completed car-diovascular fellowships and share their next career moves:

Ernesto Betancourt, MDMiami Lakes, Florida Veteran’s Administration

John Trevor Posenau, MDPrivate Practice Henrico, VA

Adam Shpigel, MDStructural Heart Fellowship Baylor University Dallas, Texas

Sangita Sudharshan, MDSt. Vincent’s Health Facility Indianapolis, Indiana

Sandeep Sodhi, MD, MBADominique Williams, MDKathleen Zhang, MDWashington University Cardiovascular Faculty

The following trainees continue in our program for subspecialty fellowship:

Advanced Heart FailureAmanda Verma, MD

Electrophysiology FellowshipCurtis Steyers, MDGeoffrey ( Joe) Orme, MD

Structural Heart Disease FellowshipMichael Daniel, MD 

Interventional Cardiology FellowshipMark Gdowski, MDChien Jung Lin, MD

ResearchGmerice Hammond, MDJesus Jimenez, MDBenjamin Kopecky, MDJonathan Moreno, MDDavid Rawnsley, MDErica Young, MD

Advanced Fellowships

The lead story on the evolution in critical

care cardiology comes at a unique time in the evolution of fellowship training pathways. As many of you may know, the American College of Cardiology’s recent Core Cardiology Train-ing Symposium (COCATS 4) highlighted the need for training in critical care cardiology, advanced cardiac imaging and adults with congenital heart disease (ACHD). The need in these important areas in cardiovascular medicine reflects both the advancement of treatment options and the increasingly com-plex nature of cardiovascular care.

Our division has been at the forefront of offering the opportunity to pursue training in these and many other non-traditional pathways. Our advanced imaging fellow-ship formally begins next year, as does our ACHD fellowship, which was approved by the ACGME last year. This year, one fellow has created a pathway focused on medical edu-cation and another on sports cardiology. We actively are in the process of developing the critical care cardiology fellowship. All of this is a hallmark of our program, which provides flexibility in the third year of training to pur-sue new avenues and cardiovascular interests.

Many aspects of these pathways, such as course work and visiting rotations, even salary support, are not always funded through traditional means. As some pro-grams around the country struggle to find resources, we find that contributions from alumni like you are crucial to our efforts to continue training leaders in cardiovascular medicine. Thank you!

New Advanced Cardiac Imaging Fellowship Begins in 2020Nishath Quader, MD, Assistant Profes-sor of Medicine, has been named direc-tor of the new advanced cardiac imaging fellowship. The fellowship, funded in part through generous contributions from alumni and faculty, begins in 2020.

Quader joined the faculty of the Cardiovascular Division in 2014 after completing an advanced cardiac imaging fellowship at Northwestern Memorial Hospital in Chicago. She earned her medical degree at North-western University Feinberg School of Medicine in 2007 and completed a residency in internal medicine at Loyola University Medical Center in Chicago

Nishath Quader, MD, to Lead New Cardiac Imaging Fellowship

Faculty Promotions

when the pathway officially begins next year. “I have a particular interest in valvular heart disease and imaging used to guide structural interventions,” she says. “Imaging allows me to explore a wide breadth of cardiovascular process-es, from heart failure to

ischemia to congenital abnormalities. It is an invaluable resource that improves both accuracy and efficiency of clinical practice. In fact, almost every cardiac sub-specialty now incorporates some aspect of cardiac imaging, so it is a field with a significant need and much potential for growth.”

Attila Kovacs, MD Professor of Medicine Shane J. LaRue, MD Associate Professor of Medicine Jiafu Ou, MD Associate Professor of Medicine

Babak Razani, MD, PhD Associate Professor of Medicine Stacey L. Rentschler, MD, PhD Associate Professor of MedicineTimothy Wm. Smith, DPhil, MD, FACC, FHRS Professor of Medicine

Nathan O. Stitziel, MD, PhD Associate Professor of Medicine and GeneticsAlan Zajarias, MD Professor of Medicine

and a fellowship in cardiology at the Mayo Clinic Foundation in Rochester, MN.

“This fellowship is invalu-able in training future cardiolo-gists in the ever expanding field of imaging and echocardiogra-phy,” she says. “Fellows will not only learn echocardiography in great depth, but also will have the opportunity to pursue other imaging modalities. In addition, fellows will have the opportunity to gain expertise in inter-ventional echocardiography and be part of this rapidly evolving and exciting field.”

Brittany Dixon, MD, currently a second-year cardiology fellow, will be the first advanced cardiac imaging fellow

The following faculty received promotions in 2019:

Bria Giacomi-no, DO, joined the division in the section of critical care cardiology in

July 2019. With a background that includes being a licensed emergency medicine technician, Giacomino completed her internal medicine residency and a cardiology fellowship at the University of Iowa. This past year she also completed a critical care fellowship at

Baylor/Texas Heart Institute in Houston, Tx.

Adam May, MD, joined the division in the section of critical care cardiology in

July 2019. May earned his medical degree from Loyola University and completed both a residency in internal medicine and a fellowship in cardiology at the Mayo Clinic in Rochester, Minn. Prior to joining the division in July, May also completed a critical care fellowship at Mayo Clinic.

Sandeep Sodhi, MD, MBA, joined the division in the electrophysiolo-gy section in

July 2019. He completed both his residency in internal medicine and his cardiology and advanced electrophysiology fellowship in the Cardiovascular Division at Barnes-Jewish Hospital at Washington University School of Medicine.

Dominique Williams, MD, joins the division in the sections of maternal fetal

and general cardiology in September 2019. She previ-ously was a cardiology fellow in the division.

Kathleen Zhang, MD, joined the division in the section of cardio-

oncology in July 2019. She previously was a cardiology and advanced cardio- oncology fellow in the division and completed her residency at Barnes- Jewish Hospital at Washington University School of Medicine.

Division Welcomes Five New Faculty

FACULTY NEWS

4 | Washington University Cardiology Alumni Newsletter

Brittany Dixon, MD, with Advanced Cardiac Imaging Fellowship Director Nishath Quader, MD

Iowa and a critical care fellowship at the Baylor Texas Heart Institute. Dr. Adam May completed both his cardiovascular fellowship and a critical care fellowship at Mayo Clinic in Rochester, MN. They will be joined by cardiologist David Schwartz, MD, assistant director of the CCU, and work under the direction of Bach and colleagues in pulmonary and critical care medicine to train fellows in the new sub-specialty pathway.

“My past year of training has been dedicated to taking care of all critically ill patients, including those in medical, cardiac, and surgical ICUs, which has given me a broad range of strategies of management,” says Giacomino. “Although patients in a cardiac ICU have severe heart disease, they can also develop other issues that affect their healing and recovery, and this past year has provided me the training to optimally address and care for all of these issues.”

Says Bach, “In many places, people with the experience of Bria and Adam don’t exist because this is an emerging subspecialty within cardiology. Our new model allows for enhanced cardiology staffing within the CCU and has the added value of bringing in cardiologists who have additional expertise in critical care medicine. That will only serve to augment our nationally recognized and already su-perlative care of our increasingly complex CCU patients.”

Attendees at the 4th Annual Michael Beard-slee Memorial Lecture in April were treated to an inspiring talk by guest speaker David Watkins, founder of the IronHeart Foundation, a nonprofit dedicated to empowering and transforming the lives of those affected by heart disease through

4th Annual Michael Beardslee Memorial Lectureactivities that foster athletic inspiration. Watkins was diagnosed with a congenital heart defect in his 30s and almost died on the operating table. After he recovered, he founded IronHeart so that cardiac patients could share stories and ultimately regain a healthy lifestyle through sport. Today, Ironheart is in 49 states and 20 coun-

tries. He also is the director of HEART: Flatline to Finish Line, a documentary profiling six individuals who went from “the hospital bed to the finish line” of the grueling IRONMAN® triathlon.

Beardslee, a former fellow, joined the faculty in the Clinical Cardiology section in 1999 and subsequently moved to private practice in 2008. He was in the process of re-joining the division faculty when he unexpectedly passed away in 2015.

Rajan Sah, MD, PhD, has joined the Cardiovascular Division, bringing with him a team of post-doctoral researchers and laboratory staff focused on understanding how ion channels regulate metabolism, with an eye toward developing new therapeutics for cardiometabolic disease.

“My research during my PhD and postdoctoral studies was on ion channel signaling at the level of the cardiac myocyte and in the context of heart failure,” he says. “But just prior to starting my independent research program I realized that there was a rich, unexplored biology of ion channel signaling in fat cells through a fortuitous collaboration with a local colleague in Boston. Shortly after starting my own lab in 2013, I followed these leads into the realms of obesity and diabetes, which are, of course, both major drivers of heart disease, and so very relevant for a cardiolo-gist to study.”

Fat cells are among the few cells in the body that can change significantly; some-times increasing 20-30 times their original size. Sah’s lab has found that a protein forming an ion channel, called SWELL1, responds in proportion to cell size and regulates insulin sensitivity in fat cells. In subsequent studies the team discovered that the same protein sensed glucose-stimulated swelling in pancreatic β-cells to regulate insulin secretion. Having identified a path-way that regulates both insulin sensitivity and secretion, the Sah lab is now beginning to develop small molecules that target this pathway for the treatment of Type 2 diabe-

New Physician Scientist Joins Division

Washington University Cardiology Alumni Newsletter | 5

Emerging CCU Care Continued from page 1

tes and metabolic syndrome. “It’s a funda-mental signaling pathway that regulates function in all cells and may have import-ant therapeutic implications for multiple disease processes, including heart disease, diabetes and fatty liver disease,” he says.

The research is significant because more than 93 million adults in the U.S. are con-sidered obese, with 30 million people in this country diagnosed with diabetes.

Sah earned both his medical and doc-torate degrees from the Institute of Medical Sciences at the University of Toronto in Ontario, Canada. He completed his cardiovascular fellowship at Brigham & Women’s Hospital in Boston and served as a post-doctoral research fellow in the cardi-ology department at Howard Hughes Med-ical Institute Children’s Hospital in Boston. He then joined the faculty at the University of Iowa before he and his research team came to Washington University.

Rajan Sah, MD, PhD, with postdoctoral research fellow Chau Ta.

David Watkins

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The Cardiovascular Division turned out in force to celebrate the 85th birthday of Robert Kleiger, MD. Kleiger is a leading expert on electrocardiography and the first to establish an echocardiography service at the former Jewish Hospital of St. Louis. He also served as director of the hospital’s Cardiac Care Unit and was interim chief of the cardiology division for three years.

Kleiger has also been on the Washington University faculty for 50 years and still delights in training resi-dents and fellows on the nuances of reading electrocardiograms. He was a resident on the Washington University ward service from 1961 to 1963. Follow-ing cardiology fellowship training at both Harvard and Stanford, he joined the Washington University faculty as an assistant professor in 1969. He was pro-moted to Professor of Medicine in 1978.

He previously donated to help fund the start-up of the division’s advanced cardiac

imaging fellowship, noting that the new pathway will “train leaders in advanced cardiac imaging and lead to better care of patients with complex cardiac problems.”

This year, Kleiger has honored the division by making an even greater charitable donation — $1 million over the next four years, which, at his request, is being earmarked for the establishment of a lectureship.

“I can’t say enough about the gener-osity of Dr. Kleiger’s to fund a lectureship that will serve to educate and disseminate some of the latest advancements in the cardiovascular field,” says Greg Ewald, MD, interim chief of the Cardiovascular Division. “He is truly an exceptional cardiologist who has made numerous clinical and research contributions during his 50 year tenure at Washington University. It was an honor for us to celebrate his milestone birthday at the same time that we thank him for his amazing gift to the division.”

Kleiger Celebrates “85” and Generously Donates to Division

Douglas Mann, MD, shares in the fun of Robert Kleiger’s 85th birthday and his 50th year in the Cardiovascular Division.